our bill hadn’t been paid for more than six months. I know that at times [physician] payments were delayed. It made me furious when I was working for the VA, and it still does. Regarding medical records, the VA is held to federal [privacy and security] standards, and VA takes [that] very, very seriously. But in that culture, employees are cautious to avoid ever making an error, and that makes them lean on the side of saying no, when some- times the right answer is yes.


Texas Medicine: The VA has used outside care before, but now Congress and others are looking to expand that option to ease the current crisis. Can this work?


Dr. Sherwood: It certainly could help, and it’s certainly a movement in the right direction. The question is, is it going far enough? Are we putting a Band-Aid on a gaping wound that needs a more drastic intervention? The last time VA was fundamentally redesigned was at the end of World War II. It’s time. n


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